Think apps are easy to design?

A German survey of elderly diabetics is proving that it isn’t easy to design a chronic disease management app that will be widely used.

Conducted by the Dresden University of Technology and Public Health Saxony and published in the Journal of Medical Internet Research (JMIR),the surveyof 32 elderly diabetic patients found that only 6 percent are using apps.

The survey participants, who averaged roughly 70 years old, were invited to try out two different diabetes apps. Their responses weren’t good. In all, 90 percent didn’t understand the apps’ functions, while 66 percent couldn’t get a handle on menu navigation or labels, 48 percent felt the font sizes were too small, 48 percent didn’t recognize touch-sensitive areas, 38 percent felt the apps “lacked individually important functions” and 34 percent felt they were unnecessary for their needs.

When asked what would make a diabetes app useful for them, 32 percent wanted the ability to add remarks to measured values, while 25 percent wanted clear definitions of threshold values and alerts when those thresholds deviated, and 25 percent wanted a reminder feature for measuring and taking medications.

The study highlights a critical issue facing the mHealth industry: Patient engagement. An app targeted for a specific chronic condition has to include functions that users would find valuable – and those functions might change among different categories of users, such as older or younger patients.

“A lack of additional benefits and ease of use emerged as the key factors for the acceptance of diabetes apps among patients aged 50 or older,” the study’s authors concluded. “Furthermore, it has been shown that the needs of the investigated target group are highly heterogeneous due to varying previous knowledge, age, type of diabetes, and therapy. Therefore, a helpful diabetes app should be individually adaptable.”

To be sure, while some studies have found that elderly consumers are ready and willing to adopt mHealth tools, others have proven that the target audience can be difficult to win over. In this study, only 47 percent even knew about apps prior to taking part, and those who said they didn’t use apps said they didn’t feel the apps offered any additional value over their regular treatment plan (50 percent), the apps wouldn’t synch with other devices or apps (12 percent), or they just didn’t like using them (12 percent).

The target population isn’t a small one. Some 397 million people around the globe between the ages of 20 and 79 are diabetic, with prevalence rates ranging from roughly 5 percent of the population in Africa to more than 11 percent in North America and the Caribbean and undiagnosed rates ranging from 25 percent to more than 50 percent. What’s more, while people aged 50 or older have more serious health conditions due to diabetes, a much larger percentage don’t use apps.